Dr. Mark Baker and his team at Children's Hospital in Birmingham, Ala., treated 60 children the night of April 27, 2011, when an outbreak of tornadoes roared across the Southeast.

Russell LewisNPR

Tornadoes killed more than 500 people in the U.S. last year — the highest number in decades. Already this year, 63 people have died, and the tornado season doesn't hit its peak until June.

But tornadoes don't have to be as deadly. Experts say some deaths could be prevented if people would do one more thing when taking cover: wear a helmet. It's a message safety advocates are preaching, but that message hasn't resonated with federal officials just yet.

'It Was Like A Vacuum'

On April 27, 2011, a horrific outbreak of tornadoes roared across the Southeast, killing more than 300 people. Some of the twisters were more than a mile wide and stayed on the ground for hours. Alabama was particularly hard hit.

"How far back do you go that day? It seemed like a normal day," says Jonathan Stewart.

He'd rushed home just minutes before a tornado swallowed up his neighborhood in Pleasant Grove, Ala. Stewart, his wife, adult daughter and 8-year-old son crowded into a tiny shower stall. It didn't take long for him to feel the house shift and become weightless — and then an explosion.

"I remember being sucked out of the house, and it was not being blown about, it was not walls blowing around. It was like a vacuum, and it sucked us out," Stewart says.

'I Actually Saw Him Up In The Air'

In an instant, Stewart's family was gone. Lisa, his wife, peered up into the swirling sea of debris and saw her son, Noah, floating above her — high above her, Lisa says: "I actually saw him up in the air, stuck up in it, being tossed around as high as the power lines."

Noah was twisting, churning, flying through the air, held up high by the tornado's angry winds. And then, Noah remembers, "the wind just immediately stopped, and I was going down headfirst, and then I think my helmet just cracked."

Noah had on a baseball helmet — the kind used in Little League with a strap and face guard. He was the only member of his family wearing protective headgear that night. In pictures taken that night, Noah's face appears fine, with just a few scratches; his parents, however, look beaten up.

Public Outreach

Noah had other injuries, and went to Children's Hospital in Birmingham. Dr. Mark Baker was working in the emergency room that night. He says most of the 60 children treated for storm-related injuries suffered some sort of head trauma.

"Children's heads are relatively large compared to the rest of their body. So during a tornado, where they're thrown by the wind or an object is thrown into them or a building collapses, it is most frequently the head that is injured," he says.

Baker says because of Noah's helmet, his injuries weren't more severe. Doctors at Children's Hospital realized they needed to do more. They partnered with a local television meteorologist to produce a PSA to tell parents that helmets help save lives during tornadoes.

Other outreach is happening, too.

At a recent Birmingham Barons baseball game, safety advocates handed out 125 bicycle helmets as part of a giveaway for tornado preparedness.

The Fulton family of Trussville, Ala., was standing in line with their three kids.

"We didn't even think anything about it last year, and then we started hearing how much safer things were once it happened and that you should wear them," says Alan Fulton. "And it's like ... 'Why didn't we do it?' I don't know."

His wife, Melissa, says wearing helmets during severe weather is "a great idea; it just never occurred to us."

'Their Silence Is Deafening'

One reason it might not have occurred to the Fultons is that the Centers for Disease Control and Prevention is silent on the topic.

But if a tornado is bearing down? The CDC recommends people use their hands to protect their heads. It makes no mention of a helmet.

For three months we tried to interview someone from the CDC, but the agency would only email a statement, which said: "The scientific evidence from helmet use during tornadoes is inadequate to make a recommendation."

This has angered safety advocates such as Russ Fine. "I think their silence is deafening," he says, "and I'm embarrassed for them — terribly embarrassed for them."

Fine's team at the Injury Control Research Center at the University of Alabama in Birmingham completed one of those scientific reports. It found many tornado deaths around the region last year could have been prevented if people had worn helmets. He doesn't understand why the CDC hasn't embraced the research.

"Will it 100 percent absolutely, positively save your life? Probably not. But it's a whole lot better than having no helmet on, and that's a no-brainer," he says.

The Beginning Of A Change

Advocates don't expect the federal government to change its recommendations anytime soon. They liken it to how long it took to get the message out about wearing seat belts or quitting smoking.

"It's the beginning of a change where research changes in the way people respond and they're advised to respond," says Sandra Koplon, of the Alabama Head Injury Foundation.

Others, such as tornado safety advocate Renee Crook, who organized the helmet giveaway at the Birmingham baseball game, says ultimately it's up to the people, not the government, to stay safe. "You have to have a plan. You chose to live here. You need to be safe. You need to be aware. You need to have a way of listening to the weather, and know when it's coming, and be prepared."

Still, many people go to government websites to learn about what vaccinations they should receive when traveling overseas, or how long to cook a certain kind of meat. Advocates hope it won't be long for the CDC to add a line about wearing a helmet when a tornado is bearing down on a community.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

STEVE INSKEEP, HOST:

On a Friday, it's MORNING EDITION, from NPR News. I'm Steve Inskeep. Renee Montagne is traveling soon to Afghanistan, and we'll hear her reports in the days ahead.

The 2012 tornado season is off to a deadly start. Already this year, twisters are blamed for the deaths of more than 60 people in the Midwest and the South. And the peak of the tornado season doesn't really begin until June. People in tornado zones know the routine. You hear the warning or the siren, and you head for cover. And now, experts are suggesting one more step that they say could prevent some deaths: wear a helmet. You see the effects and the experience of people who went through tornadoes one year ago this week.

Here's NPR's Russell Lewis.

RUSSELL LEWIS, BYLINE: Jonathan Stewart remembers very well the evening of April 27th, 2011.

JONATHAN STEWART: How far back do you go that day? It seemed like a normal day.

LEWIS: A normal day it was not. He'd rushed home just minutes before a half-mile-wide tornado swallowed up his neighborhood in Pleasant Grove, Alabama. Jonathan, his wife, adult daughter and eight-year-old son crowded into a tiny shower stall. It didn't take long for him to feel the house shift and become weightless, and then an explosion.

STEWART: I remember being sucked out of the house, and it was not being blown about. It was not walls blowing around. It was like a vacuum, and it sucked us out.

LEWIS: His family was gone. Lisa, his wife, peered up into the swirling sea of debris and saw her son Noah floating above the power lines. Here's how Noah remembers it.

NOAH STEWART: The wind just immediately stopped, and I was going down, head first, and then I think my helmet just cracked.

LEWIS: Noah had on a baseball helmet, the kind used in little league, with a strap and faceguard. He was the only member of his family wearing protective headgear, and you can tell in pictures taken that night. Noah's face was fine - just a few scratches. His parents looked beaten up. Noah had other injuries and went to Children's Hospital in Birmingham. Dr. Mark Baker was working in the emergency room that night. He says most of the 60 children treated for storm-related injuries suffered some sort of head trauma.

DR. MARK BAKER: Children's heads are relatively large compared to the rest of their body. So during a tornado, where they're thrown by the wind or an object is thrown into them or a building collapses, it is most frequently the head that is injured.

LEWIS: Baker says Noah's injuries weren't more severe because of that helmet. The hospital has even begun an outreach campaign.

(SOUNDBITE OF TV ADVERTISEMENT)

UNIDENTIFIED MAN: Children's of Alabama and CBS 42 want to encourage you to make sure your child wears a helmet anytime a tornado threatens. With your help, we can reduce the chance of head injury because our most valuable loved ones are our kids.

LEWIS: And parents aren't just learning about helmet safety from television.

MELISSA FULTON: All right, is it on there good and tight?

LEWIS: At a recent minor league baseball game in Birmingham, safety advocates handed out free bicycle helmets to be used during severe weather. Alan and Melissa Fulton picked up three for their kids.

ALAN FULTON: And we didn't even think anything about it last year, and then we started hearing about how much safer things were once it happened and that you should wear them. And it's, like, we had it. It's, like, why didn't we do it? I don't know.

FULTON: It's a great idea, we just - it just never occurred to us.

LEWIS: One reason it might not have occurred to them is the Centers for Disease Control and Prevention is silent about that. The CDC website tells motorcyclists to wear helmets because they save lives. Ditto for bicyclists. But if a tornado approaches, the CDC recommends people use their hands to protect their heads.

For three months, we've tried to interview someone from the CDC, but the agency would only email a statement. It said: The scientific evidence from helmet use during tornadoes is inadequate to make a recommendation.

RUSS FINE: I think their silence is deafening, and I'm embarrassed for them - terribly embarrassed for them.

LEWIS: That's Russ Fine. His team at the Injury Control Research Center at the University of Alabama at Birmingham completed one of those scientific reports. It found many tornado deaths around the region last year could have been prevented if people had worn helmets. He doesn't understand why the CDC hasn't embraced the research.

FINE: Will it 100 percent absolutely, positively save your life? Probably not. But it's a whole lot better than having no helmet on, and that's a no-brainer.

LEWIS: Fine and other advocates say it may be like wearing seatbelts or quitting smoking, that sometimes it takes the government a while to tell people what's best to save their lives.